__________________________________ ______________________________ Child's Name Child's Age
__________________________________ ______________________________ Parent's Name Child's Date of Birth
__________________________________ ______________________________ Address Home Phone
__________________________________ ______________________________ City Cell Phone
__________________________________ ______________________________ State Zip Code Parent's E-mai
____ T' Lights (Ages 5-8) Cinderella
____ Firelight Junior Company (Ages 9 and up) The Little Mermaid
____ Firelight Theatre Company (Ages 13 and up) You're A Good Man Charlie Brown
____ Broadway Babies (Ages 4-8)
____ On Broadway (Ages 9 and up)
__________________________________________ Parent's Signature (Participant Signature for Adults)
There is a $50.00 non-refundable registration fee for the T'Light's Camp, Firelight Junior Company, or the Firelight Theatre Company Camp and a $25.00 non-refundable registration fee Broadway Babies and On Broadway Camps. All checks should be made payable to Firelight Performing Arts.
Please mail completed registration form and payment to:
Firelight Performing Arts Academy P.O. Box 174 Milton, LA 70558